PBM Data Analyst

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Full Time Operational Level Dallas, TX, US

9 days ago Requisition

The PBM Data Analyst I at Liviniti is responsible for transforming pharmacy, healthcare, operational, and client data into trusted insights that improve pharmacy benefit program performance, operational efficiency, cost management, and patient outcomes. This role combines strong business acumen, advanced analytics, modern data platforms, AI-enabled tools, data visualization, and disciplined data governance. The analyst partners with Operations, IT, Clinical, Account Management, Compliance, and leadership teams to build reliable reporting, identify trends and anomalies, support forecasting, and recommend data-driven actions.

The following objectives further define the key job functions

• Gather, validate, and analyze data from pharmacy claims, eligibility, formulary, clinical programs, prior authorization, customer operations, pharmacy networks, vendor files, APIs, and other PBM-related sources.
• Work with structured and semi-structured data across SQL Server, Snowflake, MongoDB or other No
  
  SQL databases, cloud data platforms, flat files, and enterprise reporting environments.
• Partner with IT and data engineering teams to understand data pipelines, data models, source-to-target mappings, business rules, lineage, and data quality controls

• Write, optimize, and validate SQL queries and analytical logic to support recurring reporting, dashboards, ad hoc analysis, operational monitoring, and decision-making.
• Build and maintain dashboards, scorecards, self-service reports, and visualizations using tools such as Power BI, Tableau, Excel, or comparable business intelligence platforms.
• Analyze trends, patterns, outliers, and performance drivers across time periods, client segments, claim types, operational processes, and benefit plan designs.
• Translate business questions into analytical approaches, define KPIs, document metric logic, and present insights in a clear, actionable format for audiences

• Use AI-enabled analytics tools, natural-language query capabilities, and automation responsibly to accelerate data profiling, variance analysis, documentation, forecasting, and insight generation.
• Apply statistical techniques, forecasting methods, and basic machine learning concepts to support cost, utilization, operational, and clinical program analysis.
• Identify opportunities to automate recurring reporting, exception monitoring, data validation, and client-facing analytics while maintaining accuracy, explainability, and governance standards

• Develop and execute data validation, reconciliation, and output verification processes to ensure accurate, complete, consistent, and fit-for-purpose reporting.
• Support data governance by documenting definitions, assumptions, business rules, report logic, data sources, and change impacts.
• Protect confidential information and comply with HIPAA, PHI handling requirements, privacy policies, security standards, and internal compliance procedures.
• Assist with audits, regulatory reporting, client inquiries, and issue investigations by producing accurate, traceable, and well-documented analysis.

• Provide data-driven recommendations to improve pharmacy benefit programs, formulary strategies, prior authorization processes, claim adjudication, client outcomes, and operational performance.
• Collaborate with pharmacists, account managers, operations leaders, product owners, compliance partners, vendors, and technology teams to implement analytic solutions and resolve data-related issues.
• Communicate complex findings through concise narratives, dashboards, presentations, and recommendations tailored to leadership, client-facing teams, and operations

• Maintain confidentiality of sensitive medical information and knowledge of HIPAA Privacy and Security Rules.
• Abide by all obligations under HIPAA related to Protected Health Information (PHI).
• Report any suspected HIPAA violation to the Compliance Officer and/or Human Resources.
• Attend, complete, and demonstrate competency in all required HIPAA training offered by the company.
• Remain…